A Call for More Comprehensive Disaster Sanitation Preparedness

All citizens who pee and poop, that’s everyone, need to know how to safely take care of toileting when the luxury of a ‘flush and forget’ mentality is no longer an option. Natural disasters, such as recent Hurricanes Irma, Harvey and Maria, alter our world in unpredictable ways. One thing that we can anticipate is the disruption in the infrastructure that provides the convenience of a functioning flush toilet. The lack of education and appropriate messaging from leaders in disaster preparedness on this topic compounds problems that arise after catastrophic events. PHLUSH aims to improve the ability of citizens to respond appropriately in the face of disasters. We challenge you to become informed about how to safely deal with the result of drinking and eating – urine and feces. In the aftermath of natural disasters, there are surges of interest in preparedness but a concerning lack of emphasis on effective disaster sanitation. This blog post is focused on the United States and will present:

• Repercussions of failed sewage systems in recent natural disasters.
• Inadequate suggestions for disaster kits by leading national organizations.
• Recommendations for better disaster sanitation.

As sure as the murky black water backing up into porcelain bowls, our dependence on fragile flush toilets becomes clear.

The ramifications of sewage system failure are staggering. As a result of Hurricane Harvey, dozens of wastewater facilities were first impaired then inundated with flood waters causing pathogen rich waters to flow freely. According to the Houston Chronicle, 31.6 million gallons were dumped and over 179 sewage spills were reported across Southeast Texas. Bacteria tests of the floodwaters showed extremely high levels of fecal coliform and E. coli. Hurricane Irma caused a similar situation in Florida. The lack of power resulted in hundreds of pumping stations failing causing massive backups and eventually the outpouring of raw sewage. Millions of gallons of untreated wastewater went into streets, creeks, and homes. The fecal contamination was “beyond measure”. As journalist Emily Atkin aptly reported, ‘Florida’s Poop Nightmare Has Come True’. There are likely thousands of stories of how individuals have recently dealt with the stark reality that toilets do not actually make pee and poop disappear; they are only avenues of disposal. When those systems fail, what is the backup plan? This crucial question needs to be addressed by individuals, cities, and national organizations.

After these hurricanes, conversations that followed among sanitation engineers and wastewater managers were around the lack of generators to support the infrastructure and the loss of power in households. Discussion considered how much money it will take to replace generators and add more in the future for both Texas and Florida. However, purchasing more generators for pumping stations and households only makes the overall system more dependent on non-renewable resources rendering a vital sanitation system even more fragile. It would also be nearly impossible to outfit all points along the system from the household, pump stations, and treatment facility with a non-grid tied power source. It is time to think beyond the need for more fragile and fuel dependent infrastructure as a strategy for keeping citizens safe from sewage overflows.

US Federal Organizations Need More Toilet Talk

Federal Emergency Management Agency (FEMA) lacks adequate disaster sanitation preparedness guidelines. Our national agency for emergency management is the go-to place for how to build a preparedness kit. The top things on the list of supplies are two of our basic needs: water and food. But what about the by-product of water and food? What do we do with the natural result of drinking and eating? Down on the list, FEMA mentions “Moist towelettes, garbage bags and plastic ties for personal sanitation.” There are no instructions on what to do with these supplies. For citizens who are looking to go beyond creating an emergency kit, FEMA offers a 200-page “Are you Ready” guide that includes a more detailed itemized list for sanitation and hygiene supplies. This list adds “a small trowel for digging a latrine”, a “medium-sized plastic bucket with tight lid”, and gives more instruction on the garbage bags by saying they should be “heavy duty.’”  Again, there are no instructions for utilizing these supplies.

FEMA explicitly addresses toilets in their Instructions from the Hurricane Fact Sheet. They suggest to “fill the bathtub and other large containers with water for bathing, flushing toilets…” Then, they later describe that if there is any damage to the sewage system “do not flush toilets until you know that sewage lines are intact.” This explanation does not account for sewer backup or inundation of treatment facilities. It also leaves the homeowner to fend for themselves in the likely situation that they will not have a flushing toilet.

The Center for Disease Control and Prevention (CDC) states: “Preparedness resources include preparedness toolkits, preparedness training, and directions for emergency disinfection of water. Having clean and safe water in an emergency situation to meet drinking, sanitation, and hygiene needs is essential for every person.” They have a designated section on Personal Hygiene and Handwashing After a Disaster or Emergency where they highlight the following: Disaster Kit, Handwashing technique, When to Wash Hands, Bathing, Dental Hygiene, and Wound Care. The only mention of toilets is that you should “wash your hands after using the toilet.” There is no section on what to do when the toilet is not working. The disaster kit follows a similar format of FEMA’s: big focus on Food and Water for 3 days, no mention of what to do for the other side of drinking and eating.

In the Global Water, Sanitation, & Hygiene section, the CDC points out that “Lack of access to adequate and appropriate sanitation and hygiene can be chronic public health challenges contributing to the spread of disease in low- and medium-income countries. This situation can be made worse during environmental disasters and environmental and public health emergencies.” This message was not aimed at the United States because according to The World Bank, we are not considered a developing country. However, it would be advantageous for us to adopt some of the “Potential Sanitation Solutions During an Emergency Response” suggested. They present the advantages and constraints of different options, including container-based sanitation (buckets), and urine diversion. Social acceptance and maintenance of the systems are some of the identified challenges with implementing these systems. At the very least, emergency planners could read the approachable scientific report by Stockholm Environmental Institute, titled “Guidelines for the Safe Use of Urine and Feces in Ecological Sanitation Systems”, which provides details about differences in pathogen risk, use, and disposal of pee and poop.

National Sanitation Foundation (NSF) has a “Sanitation in Disaster Situation” webpage. One might think that an official public health and safety organization would provide clear instructions on what to do with the potentially harmful waste. Unfortunately, there is no explanation for how to sanitarily manage personal by-products in the absence of a flushing toilet. In their supply list they include the same suggestions as FEMA and the CDC.

The Ripple Effect of Poor Leadership in Disaster Sanitation Preparedness

The kits you can purchase on Amazon advertise that they follow FEMA’s guidelines for disaster preparedness, which means they provide one bucket, plastic bags, and ties. Several of the premade kits provide a MayDay Honeybucket, a company that, since 1990 has “specialized in disaster preparedness”. The Honeybucket comes with a plastic toilet seat and lid and a package of 12 plastic bags. There are no instructions on how to use the bucket or how to safely dispose of the bags. Meanwhile, businesses selling the Honeybucket advertise that it’s hygiene and sanitation products “protect against disease, infection and depression”. Others claim that their waste bags and chemicals “maintain sanitation in any setting.” The ones with chemicals provide a toilet deodorant or a compound to add into the bag that turns the mixed pee and poo into a gelatinous material. The fancy kits provide bags that already have the deodorant and the solidifier ready to go. None of these products addresses the pathogens present in the poop.

What will it take to change?

It is difficult to break long-standing taboos around publicly acknowledging that we use the toilet and depend upon them for our health. Many of us have grown so accustom to flushing and forgetting that we don’t even know where our waste goes after it leaves the porcelain bowl. Perhaps the lack of acknowledgment of our own elimination infrastructure hinders our understanding of one of our own basic needs. It is time to change our perspective to one that sees the opportunity to become more resilient by knowing how to take care of our own shit.

One of the first US cities that had the courage to talk about pee and poop with its citizens is Portland, Oregon. In collaboration with PHLUSH, the Bureau of Emergency Management developed an emergency sanitation plan. The city worked with neighborhood groups to educate its citizens on how to respond in the event of a sewer failure; in the short term and in the long-term. Today households are encouraged to be prepared to manage their own pee and poop using a Two-Bucket system, which requires toilet users to pee in one and poop in the other. The city’s ability to gain acceptance from people to separate urine from feces is a great example of leadership on this issue and has been a model for Pacific Northwest region.

So what does separation really look like?

Separation of your pee and poo is key a key to protecting the public from unnecessary illnesses from fecal contamination during emergencies. The simple act of separating your solids from your liquids in your household is perhaps a novel idea for the American public that could help us all be more resilient. You will be happy to learn that the majority (by volume) of what comes out of you is fairly benign. Your pee is not a health concern. Your poo, well that is another story. Understanding how to deal with these two very different substances is key. Separating urine means that you drastically reduce the volume of harmful material and likewise reduce smell, no small comfort in a confined space during an emergency. The nitrogen rich urine mixed with the pathogen rich poo is what creates most of the odor.

PHLUSH advocates for the Twin Bucket System. This is a simple no-mix system using two buckets with clear instructions.

1. Mark the twin buckets “pee” and “poo” (or #1 and #2, or yellow and brown, etc).
2. Set them up in a private space. The seat can be moved from one to the other.
3. Scratch your head and decide if you need to use the pee bucket or the poo bucket.
4. Try not to pee in the poo bucket.
5. After using the pee bucket remove the seat and cover with a lid that closes well.
6. After using the poo bucket, sprinkle about a half-cup of the carbon material so that it completely covers the poo. This will reduces odor and help keep flies away.
7. Toilet paper is just fine for the poo bucket but not for the pee bucket.
8. Put the toilet seat back down (keep flies out) ensuring it’s not airtight. Give your poo some air and it will dry out and reduce in volume.

Now what to do when the buckets fill up? Your pee bucket will fill up much sooner than the poo. If you have extra buckets you can store them until you have access to a compost pile, wooded area, or even a garden to deposit your nitrogen and mineral rich urine. In a dire situation you could even dump it outside or in a street culvert. Remember, you are not worried about pathogens in the pee. That is the poop bucket. The poop bucket will take longer to fill. On average, it takes about two weeks for one person to fill a poo bucket. This includes the addition of carbon material and toilet paper. When it fills, one option is to store it until regular municipal utilities are functioning. The other option is to make a receptacle for the material in the bucket out of a large wheelie bin trash can used for domestic trash. For even longer stints of time, there are methods to safely compost the by-product. For a complete guide to personal and household sanitation we recommend The Sewer Catastrophe Companion: Dry Toilets for Wet Disasters.

May we learn from the past and improve our ability to respond better in the future.

We send our heartfelt condolences to those impacted by the recent hurricanes, and sincerely hope that amid a speedy a recovery, the devastation of these hurricanes will shed light on the issues that compound the challenges of recovering from the destruction of community infrastructure. Thank you to the responders and journalists on the ground, and those who have reported on the ramifications of failed wastewater systems during hurricane Harvey and Irma. PHLUSH invites you to engage with us and to help spread the word about how individuals can be responsible for their own by-products. Please join us in the advocacy of humans having a safe and comfortable place to ‘use the toilet’. This is an opportunity here for a paradigm shift that will help us as a culture become more resilient.